Characteristics of patients with polymyalgia rheumatica based on glucocorticoid dose in Japan: A cohort study using routinely collected health data.

OBJECTIVES

This study aimed to describe the characteristics, inflammatory markers as surrogates for disease activity, and treatment of patients with polymyalgia rheumatica (PMR) in Japan.

METHODS

This cohort study analysed the data of 373 patients with PMR retrieved from an electronic medical record database in Japan. Patients were classified into quartiles, based on the daily glucocorticoid (GC) dose over the initial 90 days of treatment (Q1-Q4).

RESULTS

The low GC dose group (Q1) had more patients aged ≥90 years (11.7%) and a higher prevalence of comorbidities. At 52 weeks, GC-free remission was achieved in 10% of patients and higher C-reactive protein levels were observed during the follow-up period. In contrast, the high GC dose group (Q4) exhibited a slower decline in C-reactive protein levels and more events of increased GC dose compared to Q1-Q3. The introduction of methotrexate was low, with 4.3-7.3% of patients. The incidence of osteoporosis and diabetes was higher in patients <75 years, whereas the incidence of hypertension was higher in patients ≥75 years.

CONCLUSIONS

Patients refractory to high GC doses were identified. Patients receiving inadequately low doses of GCs were older with more comorbidities. This study highlights the unmet medical needs for PMR.